Evaluation of haematuria

Commonest benign causes:

• post exercise
• Menstruation
• UTI

Need to exclude malignancy.
Investigations

• Urine for dysmorphic cells.
  • Phase contrast microscopy is best.
  • Positive dysmorphic cells suggests glomerular bleeding.
• Complement levels
  • Low complement levels are seen in nephropathies of SLE, infective endocarditis and PSGN
• ASOT and antiDNAse-B are seen after streptococcal infection.

CO poisoning increases Alveolar arterial O2 gradient.
No vasoconstriction in CO poisoning.

• Pytiriasis is caused by malassezia species.

3. peripheral oedema.
4. Other associations
   • (hyperlipidaemia and thrombotic disease may also be present)
     • Elevated LDL and TC is the most characteristic feature.Source

Source

• Internal capsule strokes are differentiated from cortical strokes by the absence of cortical deficits.

  • Cortical deficits are as seizures, aphasia, agnosia, and dysgraphia, apraxia, alexia, and amnesia, neglect syndromes etc. and arm > leg weakness if weakness is present. (leg > arm weakness suggests cortical stroke, leg = arm weakness suggests internal capsule stroke.)

• Typical internal capsule stroke syndromes are

  1. Pure motor stroke (i.e hemiparesis)
  2. Hemiparesis with ataxia
  3. Clumsy hand - dysarthria

• Blood supply of the internal capsule:

  • Lipohyalinosis of perforating arteries is the most common cause of lacunar strokes
    LS = lenticulostriate

6. hemianopic visual loss (is an anterior circulation symdrome! not posterior circulation)

[!INFO] Recurrent artery of Huebner

The Recurrent artery of Heubner is a penetrating branch of ACA arising from the A1-A2 junction or proximal A2. It supplies parts of the internal capsule and caudate nucleus. The occlusion of the Recurrent artery of Heubner produces opposite site faciobrachial MONOPARESIS* due to the internal capsule involvement.Source

3. Language comprehension
4. Understanding social cues
5. Emotional regulation -> possibly due to involvement of the amygdala which is located in the medial temporal lobe.

Lactose intolerance

• Occurs due to deficiency of lactase enzyme.

• No weight loss or malabsorption

• pain, flatulence, borborygmi after ingesting lactose containing meal.

• Diagnosis: hydrogen breath test.

• Lactose is a disaccharide. Dietary intake decreases from infancy to adulthood.

• It's broken down by intestinal lactase to glucose and galactose which are both absorbed by intestinal SGLT-1. Failure to break down lactose reads to passage into the colon where bacterial activity converts it to short chain fatty acids and hydrogen gas. -> symptoms of bloating, flatulence, diarrhoea few hours after ingesting lactose. (?despite the process occuring in the colon)

• Soluble end products of bacterial metabolism cause osmotic diarrhoea. Source

It is the most common cause of lactase deficiency, also known as lactase non-persistence. There is a gradual decline in lactase enzyme activity with increasing age. Enzyme activity begins to decline in infancy, and symptoms manifest in adolescence or early adulthood.

• [[2021-SBR-November#Coeliac disease|Coeliac Disease]]

• Gluconeogensis in Cirrhosis

• In cirrhosis, the rate of hepatic gluconeogensis is increased and glycogenolysis is decreased. Source

• Mnemonic: "Back-up" -> upper half of the nucleus has 'back up' innvervation by the contralateral cortex.
• 

[[2020-NOV-BasicSciences#Lactose intolerance|Lactose Intolerance]]